Aging in Community Project in Sri Lanka

Sometimes, I encounter a question from my friends that

“Why are you so passionate about improving elder care?”

Each time I tried to answer the question in a past, I always fail to articulate my feeling, although I knew that I had a strong motivation for this issue deep in my heart.

When I was in Sri Lanka eating curry with my friends, I suddenly had a strange feeling about why I was in an unfamiliar country to learn about elders’ lives. Then, I questioned myself why I am interested in elder care so much that I lived in a nursing home, coming to Sri Lanka , and studying almost ten years in graduate school that is far away from my family.

At that time, again, I still could not articulate my feeling, and was struggling to come up with an answer for myself until I encountered a scene in the movie “the freedom writers.”

In that movie, an elder woman, who helped Ann Frank during the Nazism era, came and spoke to high school students in the USA . When a student told her that she would be his HERO because of her noble and brave action to protect Ann Frank under the frightening situation, she answered to him that  “I am not a HERO. I just did it because it was the right thing to do.”

Her comment brought me back the memory of talking to Jude and Bill Thomas for the first time. When I asked them why they chose the hard path to start the Eden Alternative, they said that “We are doing this because it is the right thing to do…”

It was such a great moment for me to realize myself the reason why I am doing what I am doing. It was clear that the simple concept of “doing the right thing,” has always been the guide for my path. Throughout my journey, I also learned that all the people in the culture change movement are the heroes because they are trying hard to “do the right things for elders”. Some people are nationally and internationally recognized as s “movers and shakers of culture change,” however, the real heroes are those who take care of elders in long term care facilities everyday.

I would like to always remind myself that every one of us can turn on a small right to make a brighter and better place for all of us to live together.

Despite the limited access to elderly care services in Sri Lanka , most of the elders are able to live with their family at home.  I was wandering why and how they can do this. Based on the interviews, site visits, and discussions with locals in Sri Lanka, I found that following are the factors which enable elderly people to age in their own home in the community in Sri Lanka . Unfortunately, accessibility issues are not yet addressed by any parties, while social policy report published by UN suggested for government of Sri Lanka to take immediate action.

• Buddhism tradition (Respect elders, taking care of parents)

   

• Dana (sharing and donation)

   

• Not only family members, but also relatives and neighbours share responsibility of care

   

• Inexpensive and easy access to bus transportation

   

• Availability of different transportation bus, 3wheelers, train, riding bike

   

The detail of each factor will be discussed in the following blog entries.

   
(left:Our team members, right: Delicious Sri Lankan dishes at lunch)

I safely made it back to the US. This trip to Sri Lanka was quite a life changing experience for me in many ways.

The trip gave me a wonderful and unique opportunity to think about the “real meaning of happiness.” In modern societies, people are so exhausted because they need to work hard to earn money in order to purchase the things that other people have. Many of us may believe that having a nice car, a big house, or take luxury vacations will bring happiness to our lives. When we achieve these “things”, however, their value quickly fades away. Then, we start all over again; chasing more and better things to buy without knowing if they will ever bring happiness in our lives. Although these “things” may delight us, this pleasure is rather temporary and do not come with deep sense of satisfaction.

Despite the limited access to comfort, convenience, and financial resources in people’s life in Sri Lanka, I found that their lifestyles were so much more genuine and meaningful. Many people I met appeared to know that real happiness comes from inside, from the satisfaction that one gets from giving and sharing, honoring friendships, or being grateful about what one is given. The sense of happiness is not something that we can purchase. It may require a continual action of giving and sharing with others. People in Sri Lanka diligently find opportunities to share with others, even though some may only have very limited resources. This practice seems to help them find a meaning for their lives, and ultimately bring the sense of true happiness in their lives.

Throughout this trip in Sri Lanka, I was constantly looking for the reasons why elders are highly respected and being cared for by family members and neighbors at home. Among the many possible reasons, I believe is that their cultural values of “selflessness” and “sharing” may be the most important grounds upon which the supports for elders to age in place within the community is founded.

Again, my trip was wonderful, and I have learned so much from this experience. I hope my diary was somewhat helpful ….

Since I have learned so much about elder care issues in Sri Lanka this time, I will keep posting my thoughts as well as the progress of our design project in this blog space.

My friend, Kapila, organized our visit to the Lagoswatta Eco-village which was built for the people affected by the tsunami. In this village developed by a charity organization called “Sarvodaya,” 55 houses are occupied by the individuals with various backgrounds. The village consists of residential houses, children’s playground, a multi-purpose community center including a small medical facility.

This village incorporates the ideas of:

• Developing strong community ties among residents
• Creating a sustainable living environment

Lagoswatta was built with the community’s participation. Skilled workers, such as carpenters or masons provided their talents and new homeowners as well as people from the surrounding community contributed to build the houses. In order to develop the sense of community and help residents to be financially independent, Sarvodaya provides raw materials to start an organic farm and grow mushrooms and other crop. The harvested produce would be sold at the Friday’s community market and the profit could be used to start small businesses such as bakery, general store, hair salon, etc…at the tsunami victims’ s houses. Portion of the income from the businesses would be stored in the villagers’ association to help other villagers in need. This is how people are involved in the community and take ownership in governing their community.

This village also encourages the idea of sustainable lifestyle. Technologies, such as solar panel and water system were installed to provide resources, and each household utilize compost for managing their waist as well as for fertilizing organically grown products.

According to the executive director of Sarvodaya, he had concerns in two areas, creating an integrated community among the people from four different communities, and educating new homeowners who have never cultivated anything to buy into the new ecological life style. In order to solve these concerns, staff members were sent to the tsunami camp to educate and train the new homeowners before they moved in. New homeowners’ participation in the construction process was also strategically planned.

We have spent several hours for talking to people and walking around the community. While we were there, there were so many activities happening; children were running around on the street, elders were cleaning houses, and women were doing laundry. Many were willing to show their houses to us–these were small two bedroom houses usually occupied by 5 -7 people in three generations.

When I saw the smile in their face next to their small houses, I was puzzled by comparing what I saw to the current life style in developed countries. Do I see smiles in people’s face on the street next to the beautiful houses in suburban areas? Do I even see people walking on the street there? Do big houses make us happy?

….Can we purchase a sense of community?

It is something for us to really think about in our modern society.

As a part of this project, we are planning to do some renovations/ historic preservation work on a donated property in a rural area of Sri Lanka . This property belongs to the family of the landowner for generations, and he decided to keep the name and legacy of his family by using this land to offer social services to the people in the community. The house is located in a small village in the central part of Sri Lanka, so all of our team members spent 4 days at the site after driving 6 hours from Colombo . We measured the house, visited local elders’ houses in the neighborhood, and interviewed the elders during our stay.

When we were working in that house, many elders and children came in to greet us. Among the visitors, a 79 years old, former chief of the village gave us such an intriguing comments. When I asked him whether or not he thought young people in the village would be willing to help elders in need, he looked at me with strange look. Then, asked me to repeat the question, so I did.

The old man looked at me again, and said:

“I don’t understand what you are trying to ask me. Is it a question? Yes, young people will come and help.”

I was a bit embarrassed to realize that I was foolishly trying to understand the elder care situation of this village through the lenses my past experiences. The old man also said that it was a great idea to have an aged care in the vicinity, so that he can visit elders and help them. Other villagers also said that they would welcome aged care facility in the community so that they have opportunities to help elders.

Their comments made me realize how self-centered I have become…I have never thought that elder care facilities could be perceived as a place that provide opportunities for others to give. While the villagers are relatively poor, they definitely know the real meaning of “happiness” in life.

Left: 104 years old man is singing a traditional song for us

Right: a women’s room in an aged care outside of Colombo

It takes so much effort to help elders to remain their own homes in our society today. I thought that some countries that respect elders may have easier situation for providing care at home with the help of others. However, the problems and concerns that family caregivers face everyday seem to be the same everywhere… Most of the elders in Sri Lanka are still taken care of by family, relatives, and neighbors. Moreover, due to the modernization and urbanization of our society, the concerns which are addressed by caregivers Sri Lanka are almost identical to the those in Japan and USA.

The main concerns of Sri Lankan are:

“Women have professional careers and do not have time to care for elders.”

“Children live in urban area due to their jobs, and it makes it difficult for them to care for their parents who prefer staying at their own homes in rural area.”

“There are not enough services available that benefit middle income Sri Lankan to care for their parents at home.”

“There is not enough space available for elderly parents to live in a small house.”

At this moment, people in Sri Lanka do everything they can do to take care of their own parents. While they mentioned how difficult it is to care for their parents at home, they also said “it is not easy, but we just have to find the way and do it. I cannot imagine anyone who can refuse to take care of their parents, becuase that is what we have to do.”

In order to approach these issues, Sri Lankan should come up with their own solution. When we spoke to the social policy strategists, I felt that they would  welcome the idea of providing long term care to elders who do not have family members with whom they could live. Since this country has such wonderful values of “always looking for the opportunities to help and share with others,” I hope that they will choose a different path in the future to avoid the problems that the United State and Japan have experienced through “institutional care,” which deeply disturbed social ties to family, friends, and communities as well as social roles and respect of elders.

What make people happy? ( more money? comfort? covenience?)

(left: residents’ room, right: these are everything that residents own)

I have visited one of the oldest elder care housing in Sri Lanka today. This facility was founded in 1917 and  providing care to 7 elders. Currently, 150 elderly people over 60 years old are living in this place, and 8 nurses currently provide the care with 5 administrative support staff members. They receive very little support from government due to the lack of social policy that help elderly care in Sri Lanka . The government’s support is 300 rupee ($3) a month per person, which provides only one day meal. The rest of the income is covered by the donations from community. Most of the meals served to the residents are donated (DANA) in two ways: one way is to bring home cooked meals and serve it to elders, and the other way is to donate cash ($30-$40 to cover one meal for 60 elders and all staff members).

Amazingly, people have already pledged to provide more than 98% of the meals that would be served in the coming three months. In Sri Lanka, it is common for people sign up to provide meals for elders (Dana -donation) or do a charitable act on special holidays, birthdays, memorial days of a family member, instead of receiving gifts from others. While many people in Sri Lanka do not have much access to comfort, convenience, or financial resources like in developed countries, they still practice giving and helping others. When I learned of this practice, I was quite embarrassed by my greed and selfishness.

The physical environment of this facility was quite shocking for me, because 12 elders share the same room, a dementia resident was isolated and locked in a small room, and more than 50 elders were sharing the same bathroom facility. Moreover, the culture of this organization was very much institutional, a nurse talked only about medical treatment and proud of her skills and career, and managers valued efficiency of staff members. In spite of all of these setbacks, elders in this facility seemed to be relatively happy about their lives, because they have a safe place to sleep, foods to eat, and given medical care if they need. In fact, most of them had a peaceful face with beautiful smile. One lady told me that “I am happy in any situation because I practice Buddhism. I have everything I need here, it could be better if I lived with family. But I am satisfied with living here and my life.”

After the visit, I thought that the elders in the facility might have such strength and wisdom to detach themselves from materialistic desires, and reach their inner peace to be grateful for what they have. When I saw the peaceful facial expression of the elders in this facility despite the low quality of their physical environment with the institutional operation, I was puzzled by the real meaning of the “quality of life of elders.” While developed countries such as Japan or the United States can afford to provide comfort, convenience, and safety for elders in beautifully designed living environment, I do not recall seeing anybody with such a peaceful facial expression in any elderly care settings in both countries.

It is quite ironic to learn that elders, who do not have access to a comfortable and convenient living environment, have more peace within themselves for their lives. I hope that we can do something to improve the quality of their living environment to fit with what they really deserve to have.